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Y3 CORE CONDITIONS > NECK LUMPS > Flashcards

NECK LUMPS Flashcards

1
Q

what makes up 80% of all salivary gland tumours?

A

parotid tumour

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2
Q

80% of parotid gland tumours are

a) benign
b) malignant

A

a) belign

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3
Q

give 5 malignant causes of parotid tumour

Which one is the most common

A 
Mucoepidermoid carcinoma--> most common 
adenocarcinoma
SCC
adenoid cyst carcinoma
facial nerve tumour/palsy
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4
Q

Is a thyroglossal duct cyst mobile or immobile?

A

mobile

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5
Q

what causes a thyroglossal duct cyst?

A

descent of thyroid gland

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6
Q

what is the name of the procedure used to remove a thyroglossal duct cyst

A

sistrunk procedure

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7
Q

give 3 infective causes of salivary gland swelling

A 
mumps
HIV
bacterial parotitis
CMV
EBV
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8
Q

give 3 systemic/autoimmune causes of salivary gland swelling

A

sjoren’s syndrome
sarcoidosis
wegener’s granulomatosis

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9
Q

what immune cells are affected by acute lymphoblastic leukaemia?

A

B

T

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10
Q

what is the pathophysiology of ALL?

A

uncontrolled proliferation of immature cells

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11
Q

ALL leads to failure of what?

A

bone marrow

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12
Q

in what age group is ALL most common?

a) infants
b) children
c) middle aged
d) elderly

A

b) children

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13
Q

give 6 symptoms of ALL

A 
anaemia
infection
bleeding
bone pain
organomegaly
fatigue
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14
Q

what 2 chromosome is associated with ALL?

Which is more common

A

t(12;21) most common abnormality and counts for 30% of cases
philadelphia (9:22)

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15
Q

CLL affects mainly which immune cells?

A

B cells which are mature in appearance but are actually immature and nonreactive causing immune response

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16
Q

what is the pathophysiology of CLL?

A

proliferation of immature B cells and accumulation in the bone marrow, blood, liver, lymph nodes and spleen

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17
Q

what percentage is CLL of all leukemias?

a) 1%
b) 25%
c) 50%
d) 75%

A

b) 25%–> most common leukemias

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18
Q

what group are mainly affected by CLL?

a) young females
b) young males
c) old females
d) old males

A

d) old males

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19
Q

where might you expect pain in CLL? why?

A

LUQ (splenomegaly)

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20
Q

what is a cystic hygroma?

A

lymphatic malformation causing a mass

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21
Q

what is a infantile haemangioma?

A

A benign tumour of cutaneous blood vessels on the face of a child.
Occurs after birth, blood lump

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22
Q

how common is infantile haemangiona?

a) 1-2%
b) 10-12%
c) 20-30%
d) 40-50%

A

b) 10-12%

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23
Q

are infantile haemangiomas more common in males or females?

A

males

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24
Q

infantile haemangoimas tend to proliferate in the first __ months and settle before the age of __

A

9

4

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25
Q

what is chronic myeloid leukaemia?

A

uncontrolled proliferation of myeloid cells

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26
Q

what percentage of all leukemias is CML?

a) 1%
b) 15%
c) 40%
d) 60%

A

b) 15%

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27
Q

what age group is most commonly affected by CML?

A

middle aged

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28
Q

which of these words does not describe CML?

a) chronic
b) self-limiting
c) insidious

A

b) self-limiting

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29
Q

why is CML associated with gout?

A

purine breakdown

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30
Q

where might you expect pain in CML? why?

A

LUQ- splenomegaly

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31
Q

What chromsome is linked to CML?

A

Philadelphia (9:22)

80% of cases

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32
Q

what is acute myeloid leukaemia?

Is it more common in males or females?

A

blast cell proliferation from myeloid bone marrow

M>F

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33
Q

what is the most common acute leukemias in adults?

A

AML

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34
Q

which leukemia can arise as a complication of chemotherapy

A

AML

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35
Q

give three symptoms of marrow failure characteristic of AML

A

anaemia
infection
bleeding

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36
Q

what is the prognosis of AML like?

A

poor

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37
Q

what is hodgkin’s lymphoma?

A

proliferation of lymphocytes that accumulate in lymph nodes

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38
Q

which is the rarest of hodgkin’s and non-hodgkins

A

hodgkin’s more rare

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39
Q

what are the B symptoms classic of HL and NHL?

A

fever
night sweats
weight loss

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40
Q

which cells are characteristic of HL?

A

reed-sternburg cells (multinucleated giant cells)

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41
Q

what viral infection is linked to HL?

A

EBV mononucleosis

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42
Q

what staging is used for HL?

Describe the stages

A

ann-arbour
Stage 1: single lymph node group involvement
stage 2: multi lymph node groups involvement on same side of diaphragm
stage 3: multi lymph node groups on both sides of diaphragm
stage 4: Extranodal involvement plus lymph nodes

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43
Q

what is non-hodgkin’s lymphoma?

A

Malignant tumour of lymphoid cells but can also be found on in other cells such as lung, skin, esophageal cells

44
Q

which cells are most commonly affected by NHL?

A

B

45
Q

what type of lymphoid cells can be affected by NHL? which is more dangerous?

A

mature or proliferating

proliferating more dangerous

46
Q

B symptoms are more common in HL or NHL?

A

HL

47
Q

give 3 viruses associated w NHL

A

EBV
herpes
HIV

48
Q

give a bacteria associated with NHL

A

h pylori

49
Q

what occupational exposure can be associated w NHL?

A

farms (pesticide exposure)

50
Q

what is the childhood version of NHL?

A

burkitt’s

51
Q

which chromosomes are translated in burkitt’s?

A

8 and 14

52
Q

give an example of a drug treatment for NHL

A

rituximab

53
Q

along the border of which muscle would a brachial cleft abnormality run?

A

sternocloidomastoid

54
Q

what can brachial cleft abnormalities predispose to?

A

URTIs

55
Q

who do brachial cleft abnormalities normally affect?

A

young adults

56
Q

What are the 4 classifications of Hodgkin lymphoma?

A

Nodular sclerosis
Mixed cellularity
Lymphocytic depleted
Lympochytic rich

57
Q

What classification are 5% of all Hogdkin lymphoma?

A

Nodular lymphocyte predominately hodgkin lymphoma

Popcorn cells

58
Q

What are the risk factors of HL?

A 
Smocking
Immunodeficiency
Obesity
EBV
FHx
59
Q

What 2 organs can enlarge in HL?

A

Splenomegaly and hepatomegaly

60
Q

What are the initial symptoms of HL and NHL?

A

Painless lumps in the lymph nodes–> neck, groin and axilla

61
Q

Except for B symptoms what other symptoms do you get with HL?

A

anorexia
Pruritus
Fatigue

62
Q

How do you diagnose HL and NHL?

A

biopsy and bloods

63
Q

What are the treatments for HL and what is the survival rate?

A

Chemo and Rado
BM transplant
5 years

64
Q

What can NHL be divided into?

A

High grade and low grade NHL

65
Q

What is the 2 most common types of B cell NHL?

A

Diffuse large B cell lymphoma

Follicular lymphoma

66
Q

What are the 2 most common types of T cell NHL?

A

Peripheral T cell lymphoma

Skin lymphoma

67
Q

What autoimmune conditions are associated with NHL?

A

RA

Hashimotos

68
Q

Does having previous cancer treatment and FHx of NHL increase chance of NHL?

A

yes

69
Q

As well as B symptoms what other symptoms might you get with NHL?

A

Anaemia, bleeding, pancytopenia, infection

70
Q

NHL can spread to the bone marrow causing reduction in RBC,WBC and platelets what is the effect?

A

Tired (RBC)
Bleeding and brusing (platelets)
Infection (WBC)

71
Q

IF NHL goes into the lungs what are common symptoms?

A

Difficult breathing, swallowing and coughing

72
Q

IF NHL goes into the abdomen what are common symptoms?

A

Weight loss, tummy pain and indigestion

73
Q

Is high grade or low grade NHL curable?

A

High grade

74
Q

What percentage of people with
a) high grade
b) low grade
survive 5 years?

A

a) 30%

b) 50%

75
Q

What treatment is given to NHL that is
a) local disease
or
b) diffuse disease

A

a) radiotherapy

b) monoclonal antibody

76
Q

Give a example of monoclonal antibody?

A

Rituximab

77
Q

Which is more common HL or NHL and by how much?

A

NHL is 5 times more common

78
Q

What is Warmiths tumour?

A

The second most common benign salivary gland neoplasm that occurs in 60’s of females and 70’s of males

79
Q

What are the red flags for parotid/salivary gland tumour

A

Facial weakness/palsy
Sudden increase in size
Paraesthesia/anaesthesia of neighbouring nerve
Intermittent pain/restlessness
Ulceration of the skin around the infected area

80
Q

During parotid tumour investigation US is initially is done why is then MRI or CT done?

A

If deep tissue is infiltrated

81
Q

What is the treatment for parotid tumor?

A

Radiation, parotidectomy ( careful dissection of facial nerve) and laryngectomy
Surgery is difficult due to the positioning of facial nerve and relapse often happens

82
Q

What bacteria commonly causes bacterial parotitis that causes salivary gland swelling?

A

Staph Aureus

83
Q

What are the three stages of treating ALL? Explain each stageWhat

A

Induction–> initial stage and killing all the leukaemia cells in the bone marrow= restore balance to the cells and resolve any symptoms
Consolidation–> Kill any leukaemia cells in the CNS
Maintenance–> Regular chemotherapy to ensure no relapse

84
Q

What are the risk factors for ALL?

A 
Smocking ( even parents smoking)
Previous chemotherapy 
Obese
Genetics
Immunodeficiency
85
Q

Do patients with CLL commonly present with symptoms?

A

Over 90% are asymptomatic and incidental finding on routine blood test

86
Q

How do you diagnose CLL?

A

Blood test –> increase WCC 5* 10(9)/L
Blood film
Lymph node and BM biopsy

87
Q

What are the three stages of CLL?

A

Stage A–> have enlarged lymph glands in less than 3 areas but increase WBC count
Stage B–> have enalrged lymph glands in 3 or more areas and increased WCC
Stage C–> all glands are enlarged and splenomegaly and increase WCC but decreased RBC and/or Platelets

88
Q

At what stage do you start giving treatment for CLL and what is that treatment?

A

Chemotherapy and Stage B and C

89
Q

What is the least commonest leukaemia of the 4?

A

CML

90
Q

There are 3 stages of CML explain each stage?

A

Initial chronic phase, usually asymptomatic with little blast cells. Last for average of 4-5 years with incidental finding
Transformation phase–> increasing amount of blast cells and developing of symptoms
Blast phase–> mainly blast cells and resembling AML

91
Q

What symptoms are commonly seen in transformation stage of CML due to increase production of blast cells

A

Anaemia
Serious infection
Blood clotting problems

92
Q

What are the
a) B symptoms
b) additional symptoms and signs
you ge tin CML?

A

a) Night sweats, fever, tiredness (from anaemia) and weight loss
b) splenomegaly, hepatomegaoly, reccurent infections, petechiaea and lymphadenopathy

93
Q

What is the main treatment for CML and how does it work?

A

Imatinib tablet –> tryosine kinase inhibitor
It inhibits tryosine kinase a enzyme that is produced by Philadelphia chromosome and involved in the abnormal growth and behaviour of the cells

94
Q

What is mucoepidermoid carcinoma linked to ?

A

Cytomegalovirus

95
Q

What are the characteristics of mucoepidermoid carcinoma?

A

Slow growing, palpable and firm mass

Squamous cell and mucus secreting

96
Q

What tumour can cause mets in the parotid?

A

Phyllodes tumour of the breast

97
Q

What is the characteristic of adenoid cyst carcinoma?

A

Well differentiated and slow growing

98
Q

What is the complication with treatment of Parotid tumour?

A

Frey’s syndrome which is damage to the auriculotemporal nerve and causes sweating when eating

99
Q

What is the cause of salivary gland stones and the symptoms?

A

Crystallised salivary deposits

Block the saliva causing pain and swelling

100
Q

What is SIALADENITIS ?

What are the symptoms?

A

It is infection of the salivary gland when it is blocked

Affects one side of the gland and you get bad taste in the mouth due to the pus drainage

101
Q

What are the risk factors and complications of sialadenitis?

A

RF–> dehydration and malnutrition

Complication –> Abscess, sever pain and fever

102
Q

What is the cause of cyst in salivary swelling and what is the symptoms?

A

Tumour, infection, trauma and stones

Interfere with speaking and eating

103
Q

What are the symptoms of SJORGREN’S SYNDROME

A

Dry mouth and eyes

Bilateral painless enlargement of glands

104
Q

Treatment for salivary gland swelling

A

Manual removal of stones
Surgery in extreme cases
Abx for bacterial infection
Sour candies to increase salivary flow

105
Q

Which of the leuekmia is associated with gout?

A

CML due to breakdown of purine

Y3 CORE CONDITIONS (15 decks)

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